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General NPI Number Information
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NPI Number | 1730560665
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Entity Type | Individual
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Provider Name | JILLIAN JACKSON WILLIAMS LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/16/2015
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Last Update Date | 01/26/2023
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Provider Practice Location Address
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Address Line | 104 1/2 FORREST AVE
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City | NARBERTH
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State | PA
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Zip | 19072-2220
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Country | US
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Telephone | 215-534-1604
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Fax |
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Provider Business Mailing Address
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Address Line | 828 MERRILL RD
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City | AMBLER
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State | PA
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Zip | 19002-2645
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Country | US
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Telephone | 215-534-1604
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW132001
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW019953
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License Number State | PA
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